# Pre-hospital Identification of a Giant Bladder Calculus through Screening Sonography: A Case Report

## TL;DR

Screening ultrasound in remote areas helps identify bladder stones early, aiding timely patient referrals.

## Contribution

Demonstrates the utility of screening sonography in pre-hospital settings for urological emergencies.

## Key findings

- Screening ultrasound detected a large bladder calculus in a remote emergency setting.
- Images from basic facilities matched those from specialized units, supporting diagnostic accuracy.
- Early ultrasound use improved patient triage and safety in areas with limited medical resources.

## Abstract

Screening ultrasound proves to be remarkably beneficial in pre-hospital settings, particularly in geographically remote areas with technological constraints and no medical specialties. Urological pathology has a high frequency of occurrence in the emergency department and is part of the wide range of occurrences that can benefit from this ultrasound screening as a clinical guide for patients.

In this case, a patient experiencing lower abdominal pain and symptoms of renal colic sought assistance at a basic emergency service facility. Utilizing a renal screening ultrasound executed by a sonographer, the clinical team identified images indicative of a significant bladder calculus. Subsequently, the patient was referred to a referral hospital for a comprehensive evaluation by medical specialties.

The images obtained in both health units exhibited congruence, indicating that the screening ultrasound, while not intended to replace the specialized orthodox ultrasound executed by a radiologist, served as a crucial tool for diagnostic presumption, providing consistency in clinical decision-making for referring patients. This capability allowed emergency physicians to promptly transfer a patient requiring urgent further investigation to a referral hospital with compelling and substantiated data. This shift in the approach to patient triage in a remote setting could enhance patient safety.